Pediatrics International最新文献

Background: Korean infants born at 32-35 weeks gestational age (wGA) receive palivizumab prophylaxis to prevent respiratory syncytial virus hospitalization (RSVH) if they are born during the RSV season and have a sibling. The aim of this study was to evaluate the impact of using the International Risk Scoring Tool (IRST) to target prophylaxis in Korea.

Methods: The IRST includes 3 risk factors: birth 3 months before to 2 months after the RSV season starts; smokers in the household and/or smoking while pregnant; and, siblings/daycare. First, the accuracy of the Korean guidelines to predict RSVH was compared to that of the IRST using a historic dataset of 13,475 infants born 32-35 wGA. Second, a published cost-utility model was adapted using Korean-specific parameters for costs (2022) and resource use to assess the cost-effectiveness of palivizumab versus no prophylaxis guided either by the Korean guidelines or the IRST.

Results: Using the Korean guidelines identified 26.9% of RSVHs, with an area under the receiver operating characteristic curve of 0.512. The corresponding results for infants assessed at moderate- to high-risk by the IRST were 85.1% and 0.773, respectively. The incremental cost per quality-adjusted life year (QALY) for prophylaxis versus no prophylaxis was ₩29,674,102 (USD22,977) using the Korean guidelines, with a 67.0% probability for cost-effectiveness against a willingness-to-pay threshold of ₩41,655,203 (USD32,255). For the IRST, it was ₩26,265,142 (USD20,338)/QALY and 70.8% probability.

Conclusions: Adoption of the IRST in Korea would provide greater protection of the most vulnerable infants born 32-35 wGA against RSVH whilst improving cost-effectiveness.

Background: Our study aims to investigate the relationship between autistic traits, social media addiction, and loneliness among adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD) and to compare our findings with healthy controls.

Methods: A total of 90 adolescents aged 14-18 years, 50 of them diagnosed with ADHD and 40 healthy controls, were included in our study. Adolescents participating in our study were evaluated with the Conners' Parent Rating Scale-Revised: Short Form (CPRS-R:S), the Autism Spectrum Quotient-Adolescent Version (AQ-Adolescent), the 9-item Social Media Disorder Scale (SMD) and the UCLA Loneliness Scale Short Form (ULS-8). The SPSS 25.0 program was used in the analysis. p < 0.05 was accepted as the significance level.

Results: It is found that adolescents diagnosed with ADHD had statistically significantly higher scores on the communication, social skill, imagination, attention switching subscales, and total score of the AQ-Adolescent compared to healthy controls. Moreover, adolescents diagnosed with ADHD obtained statistically significantly higher scores from the SMD and the ULS-8 compared to healthy controls. The ULS-8 showed a significant positive correlation with the AQ-Adolescent and the SMD in the ADHD group. It was also found that only loneliness may be associated with the risk of developing social media addiction in adolescents with ADHD.

Conclusions: The results of our study indicate that adolescents diagnosed with ADHD are susceptible to encountering challenges regarding social difficulties, feelings of loneliness, and social media addiction. It is believed that it may be essential to address these factors when dealing with social media addiction, which is prevalent among adolescents diagnosed with ADHD.

Background: Intractable vascular anomalies (VAs), including vascular tumors and venous, lymphatic, and mixed malformations, often have severe symptoms and a poor prognosis, highlighting the need for new treatments. We conducted a prospective trial of sirolimus (tablet and granule forms) for the treatment of VAs.

Methods: In this open-label, single-arm, multicenter trial across four Japanese institutions, patients with VAs received oral sirolimus daily, targeting a trough concentration of 5-15 ng/mL. We evaluated response rates (radiological volume changes in lesions), skin lesions, performance status, respiratory function, visceral symptoms (bleeding, pain), laboratory data, quality of life, and safety at 12, 24, and 52 weeks.

Results: Thirteen patients with VAs were treated with sirolimus. Seven patients (53.8%; 95% confidence interval: 25.1%-80.8%) showed a partial radiological response at 24 weeks, with no complete responses, and 61.5% had a partial response by 12 weeks, with little subsequent change in patients who had stable disease thereafter. Improvements in skin lesions, blood coagulation, and activities of daily living were noted. Common adverse events included stomatitis, dermatitis, diarrhea, and fever.

Conclusions: Sirolimus may reduce VA tissue volume and potentially improve symptoms and activities of daily living in patients with VAs.